Top 10 Healthcare Quality Issues for 2011

Even Massachusetts Rep. Edward J. Markey has weighed in to the controversy by saying that hundreds if not thousands of people were being unwittingly exposed to radioactive isotopes simply because they had been in close proximity of patients who had recently undergone therapy with high doses of radioactive isotopes.

With the concern that too many doctors are ordering too many unnecessary tests involving radiation, the Centers for Medicare & Medicaid Services has even launched a demonstration project to build a decision support system. The idea is that physicians who aren't sure about whether a test is warranted could use such tools to make the right choices for their patients.

2. Dialysis Mortality
The number of patients with end-stage renal disease continues to take a toll on the federal budget as the number of Americans receiving federally supported dialysis as a lifelong treatment option sits more than 400,000, at costs as high as $77,000 per patient per year. Dialysis mortality makes our list of top quality issues for 2011 as regulations come under scrutiny.

Care for dialysis patients is plagued with disparity and extremely high death rates, depending on where one receives care. For every five people who begin dialysis at the beginning of the year, one won't be alive at the end of it. But at some facilities, the death rate is as high as 30% per year.

ProPublica this year has exposed some of the reasons for the disparity such as high infection rates, low quality standards, and poor regulation of the industry. It said "two corporate chains that dominate the dialysis-care system are consistently profitable, together making about $2 billion in operating profits a year."

Anne Jarrett MS, RPh (2/7/2012 at 4:55 PM)
I would like to add a comment on the subject of dialysis and the expense related to it. I am a pharmacist who established a pharmacy at a transplant center to help patients obtain their medications, and I have a unique perspective. The meds transplant patients take are very expensive, even after Medicare pays 80%. After transplant,Medicare covers these patients for 3 years only. I saw patients who could not afford their meds, did not take them, and often had to be readmitted numerous times to receive I.V. drugs. Drug manufacturers have ever changing pt. assist. programs,rendering a sig. amt. of pts. ineligible. Result:Patients were re-transplanted only to start the cycle again. All of which was paid for by Medicare,including being,back on dialysis while waiting for another kidney. What's wrong with this picture?

Helen Erickson (1/7/2011 at 9:34 PM)
This approach has been around for many years, has been demonstrated to be effective, but requires a mind set about the worth of the person's self-care knowledge. The attached video provides information about the use of this approach at The Univer of TX Health Science Center, San Antonio http://www.youtube.com/watch?v=DhYeeVghhQU

Bogey (1/4/2011 at 9:00 AM)
Interesting that none of the concerns from the provider perspective is about lowering the cost of care, the single largest driver of high insurance prices and medicine today. And one wonders when providers will "get it," that it is the rising cost of care and the lack of MARKET forces (not government regulation) to drive down cost that propels us toward the iceberg, as providers rearrange the chairs on the deck of the Titanic.

The Obama administration said Tuesday that it had shelved plans for a survey in which "mystery shoppers" posing as patients would call doctors' offices to see how difficult it was to get appointments. "We...

With the prohibitive and rising cost of healthcare, there has never been a greater need for accountable care organizations, according to Mark McClellan, MD, former administrator for the Centers for Medicare...

With drug prices rising and many people out of work, pharmaceutical companies are increasingly helping patients with their co-payments. The use of such co-payment cards and coupons and other types of...